Recurrence patterns identify aggressive form of human papillomavirus-dependent vulvar cancer
Aims: To assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality.
Materials and Methods: A retrospective cohort study of NT-resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events.
Results: Indigenous women from Arnhem Land experienced more recurrences after treatment than non-Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years.
Conclusion: In characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population.
Funding
National Health & Medical Research Council
History
Publication title
Australian and New Zealand Journal of Obstetrics and GynaecologyPagination
1-7ISSN
0004-8666Department/School
Faculty of LawPublisher
Royal Australian N Z College Obstetricians & GynecologistsPlace of publication
254-260 Albert St, East Melbourne, Australia, Vic, 3002Rights statement
© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists This is the peer reviewed version of the following article: McWhirter, R. E., Otahal, P. , Taylor‐Thomson, D. , Maypilama, E. L., Rumbold, A. R., Dickinson, J. L., Thorn, J. C., Boyle, J. A. and Condon, J. R. (2019), Recurrence patterns identify aggressive form of human papillomavirus‐dependent vulvar cancer. Aust N Z J Obstet Gynaecol., which has been published in final form at https://doi.org/10.1111/ajo.13075. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Repository Status
- Restricted